Humanitarian Situation Update #173 | Gaza Strip

The Humanitarian Situation Update is issued by OCHA Occupied Palestinian Territory three times per week. The Gaza Strip is covered on Mondays and Fridays, and the West Bank is covered on Wednesdays. The “Humanitarian Situation Update” is a rebranding of the “Flash Update”. The next Humanitarian Situation Update will be published on 3 June, and the next Humanitarian Response Update will be published on 12 June.

Key Highlights

• Only 14 of Gaza’s 36 hospitals are functional, all of them partially, facing critical shortages, the World Health Organization (WHO) reports. In Rafah, only three field hospitals are still operating, one of them partially. 
• The World Food Programme (WFP) calls for the immediate opening of all access points, emphasizing that its ability to support people in need is deteriorating. 
• Health and environmental risks are on the rise due to fuel shortages, limited access to clean water, sewage overflow, accumulation of solid waste, and infrastructural damage, UNRWA and partners warn.  
• Two Palestine Red Crescent Society paramedics were killed while on duty in Rafah. 

Humanitarian Developments 

• Israeli bombardment from the air, land, and sea continues to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of houses and other civilian infrastructure. Ground incursions and heavy fighting also continue to be reported, particularly in Rafah. Intensified hostilities following the issuance of evacuation orders and the Israeli military operation in Rafah have so far forced the displacement of about one million people, amid a decline in the entry of humanitarian aid. 
• Between the afternoons of 29 and 31 May, according to MoH in Gaza, 113 Palestinians were killed and 637 were injured, including 60 killed and 280 injured in the past 24 hours. Between 7 October 2023 and 31 May 2024, at least 36,284 Palestinians were killed and 82,057 were injured in Gaza, according to MoH in Gaza.  
• The following are among the deadly incidents reported between 28 and 30 May:  
  • On 28 May, at about 11:35, four Palestinians, including a child, were reportedly killed and others injured when a group of Palestinians was hit in Al Fallujah area of Jabalya Refugee Camp, in North Gaza. 
  • On 29 May, at about 1:00, three Palestinians, including two children, were reportedly killed when a house was hit in Ma’an area, in eastern Khan Younis. 
  • On 29 May, at about 14:30, at least seven Palestinians, including at least two girls, were reportedly killed and others injured when a house was hit in eastern Khan Younis city. 
  • On 29 May, at about 22:25, at least five Palestinians were reportedly killed and others injured when a residential building was hit in Ad Daraj area, in Gaza city. 
  • On 30 May, at about 3:20, four Palestinians, including two women, were reportedly killed and 15 injured when a house was hit in Bloc C of An Nuseirat Refugee Camp, in Deir al Balah. 
• Between the afternoons of 29 and 31 May, three Israeli soldiers were reported killed in Gaza. As of 31 May, 293 soldiers have been killed and 1,848 soldiers have been injured in Gaza or along the border in Israel since the beginning of the ground operation, according to the Israeli military. In addition, according to the Israeli media citing official Israeli sources, over 1,200 Israelis and foreign nationals, including 33 children, have been killed in Israel, the vast majority on 7 October. As of 31 May, it is estimated that 125 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld. 
• On 29 May, at about 23:00, the Palestine Red Crescent Society (PRCS) reported that two of its paramedics were killed while on duty in Tal as Sultan area in western Rafah. In a statement on 30 May, PRCS said that the killing was caused by an airstrike that directly hit the front of one of three ambulances on a humanitarian mission and when the remaining ambulance crew tried to extinguish the fire, Israeli troops opened fire toward them, forcing them to withdraw. The bodies were retrieved the next morning. PRCS called for accountability to ensure that the targeting of protected persons, including medical teams, stops. In response to the incident, the International Federation of Red Cross and Red Crescent Societies (IFRC) stated: “Protecting humanitarian workers is a legal and moral obligation. The level of human suffering in Rafah and overall in the Gaza Strip is unconscionable. More than one million people, including PRCS volunteers and staff, have fled multiple times in search of safety with no access to basic services.” Since the intensification of hostilities in October 2023, at least 270 aid workers have been killed in Gaza, including 192 UNRWA staff, four other UN staff, at least 42 other aid workers, and 32 PRCS staff and volunteers of whom 19 were on duty.  
• The alarming trend of key humanitarian facilities being forced to close in Rafah is continuing. On 30 May, Médecins Sans Frontières (MSF) reported that, due to the Israeli military operation in Rafah, it had closed a primary care centre in Al Mawasi. On 27 May, “due to extreme violence,” the NGO had already been forced to evacuate a WHO-supported Trauma Stabilization Point in Tal As Sultan area, a critical facility that just one day prior had received over 180 patients injured in the 26 May airstrike on tents sheltering internally displaced persons (IDPs). Overall, since October, MSF has been forced to leave 14 medical facilities in Gaza. SOS Children’s Villages also announced that it had started on 28 May the emergency relocation of children and adults from the SOS Village in Rafah to an alternative location in central Gaza “due to a dramatically heightened security risk.” The facility has thus “ceased to be a humanitarian hub for the local community and IDPs in Rafah,” stressed the NGO, adding that many of the children had already been displaced several times to escape the fighting. The Malnutrition Stabilization Centre in Tal as Sultan area has also completely ceased operations, according to the Nutrition Cluster, and efforts are ongoing to relocate its services to Nasser Medical Complex in Khan Younis.  
• The remaining health facilities in Gaza continue to face dire shortages of fuel and other vital supplies and equipment. On 29 May, the WHO Spokesperson, Dr. Margaret Harris, reported that only three WHO trucks had entered Gaza through the Kerem Shalom crossing since the Rafah incursion began, while 60 other WHO trucks were stuck in Al Arish, Egypt. In Rafah, key health services, such as dialysis, medical imaging, surgery, internal medicine, and maternity and pediatric care, are no longer available, and many of the highly skilled doctors and nurses have been displaced from the city. With Al Emirati Maternity Hospital ceasing operations, all three hospitals in Rafah that were partially functional prior to the Israeli military operation are now out of service. Just two overwhelmed and undersupplied field hospitals remain operational in the governorate, while a third one is inaccessible and only partially functional, according to WHO. Across Gaza, all medical teams are facing enormous challenges in meeting needs and are watching patients die as they lack either the tools, skills or supplies to do what is needed, underscored Dr. Harris, adding that doctors are struggling with infection prevention and control and are being forced to take difficult decisions, as removing a limb to save a life. The lack of CT scans south of Wadi Gaza means that doctors are not even able to see bone fractures to realign them in the most appropriate way. In the same way, treating severe burns requires intensive care and high-level medical services no longer available in the Strip, a message echoed by the WHO representative in the occupied Palestinian territory, Dr. David Peeperkorn. MSF has similarly highlighted that essential equipment needed for treatment, including generators, water pumps, scanners, X-ray, oxygen and sterilization items, continue to be outrightly blocked or face “appalling delays” in entering Gaza.   
• Pregnant and breastfeeding women have been living “in an unrelenting nightmare,” underscored UNFPA, warning that premature and complicated births have increased as pregnant women are stressed, scared, malnourished and exhausted. Overall, some 18,500 pregnant women have been forced to flee to Khan Younis and Deir al Balah, where access to maternal health care is minimal, while another 10,000 are estimated to have remained in Rafah amid desperate conditions. Beyond a critical shortage of maternal and reproductive health services and supplies, “many face the threat of famine and lack even the basics for survival,” emphasized UNFPA. 
• On 30 May, WFP called for the immediate opening of all access points, as the Rafah exodus fuels hunger. The Israeli military operation in Rafah is having a devastating impact on civilians and humanitarian operations, WFP added, with adults and children beyond exhausted by constant displacement, hunger, and fear. WFP warned that further escalation could deepen the humanitarian catastrophe and bring aid operations to a standstill as constrained access to the southern parts of Gaza is driving a rapid deterioration in hunger levels similar to those previously witnessed in the north.  
• Food aid agencies are struggling to access humanitarian aid, particularly from Kerem Shalom crossing, due to active conflict, impassable roads, unexploded ordnance, fuel shortages, delays at checkpoints, and Israeli restrictions. “We need Israeli authorities to facilitate pick-up and delivery of humanitarian supplies entering Kerem Shalom – the opening of a border crossing is not enough,” WFP appealed as its ability to support people in need is deteriorating. Although recent deliveries of humanitarian aid and fuel from Egypt through the Kerem Shalom Crossing are positive steps, sustained access is essential. Fuel shortages also remain a major concern, affecting trucks, hospitals, sewage systems, desalination operations and bakeries. Out of 17 bakeries WFP supports in Gaza, only 11 are now operating due to the lack of cooking gas and other essentials as well as ongoing hostilities; these include one bakery in Jabalya, four in Gaza city, and six in the south. 
• Fuel reserves necessary for operating critical water and wastewater facilities have reached critically low levels, with only 30,160 litres provided to these facilities between 20 and 26 May, or about 43 per cent of fuel requirements per day, according to the Water, Sanitation and Hygiene (WASH) Cluster. This shortage, combined with the shutdown of power supply, has led to a two-day suspension of water production and associated water trucking at the two main desalination plants in central and southern Gaza, resulting in lost production of about 4,500 cubic metres per day on 25 and 26 May. Water production at the third main water desalination plant in northern Gaza had already stopped in October. In addition, while all three Mekorot water lines from Israel are now operational, the one in central Gaza and the one in southern Gaza are operating at only 50 per cent of their capacity. Access to safe drinking water at the IDP sites in Khan Younis remains insufficient to meet needs, the Cluster reports, although it has somewhat improved following the establishment of ten new water distribution points. Overall, water production currently stands at about 80,000 cubic metres per day, only about 21 per cent of the 374,000 cubic metres per day produced prior to the intensification of hostilities in October. 
• People across Gaza are facing heightened health and environmental risks owing to limited access to clean water, sewage overflow, infrastructural damage, and a lack of hygiene items, reports the WASH Cluster. About 60 per cent of all water and sewage facilities have been destroyed or damaged, according to the Cluster. In Khan Younis, there are no functional sewage pumping stations and displaced families are building their own makeshift latrines amid a lack of basic materials to improve sanitation conditions. In Gaza city, the lack of fuel to pump sewage has led to the accumulation of an estimated 500,000 cubic metres of stagnant sewage in Sheikh Radwan Lagoon.  
• The fuel deficit and lack of safe access to the two main landfills have additionally hampered solid waste collection services, resulting in the accumulation of trash across the Gaza Strip. Noting that UNRWA staff have been denied access to landfills by Israeli authorities and many of the agency’s sanitation centres, machinery and trucks for removing trash have been destroyed, UNRWA spokesperson, Louise Wateridge, stressed: “As the weather gets warmer, it just creates more problems, not only with the stench but with the spread of diseases and with pests like mice, rats and mosquitoes which make diseases spread even more.” Coupled with the lack of clean water, this continues to fuel rising numbers of acute respiratory infections, diarrheal illnesses, including bloody diarrhoea, and Hepatitis A, warned the UNRWA Director of Health, Dr. Akihiro Seita, on 28 May. 

Funding

• As of 31 May, Member States have disbursed about US$1 billion out of $3.4 billion (30 per cent) requested to meet the most critical needs of 2.3 million people in Gaza and 800,000 people in the West Bank, including East Jerusalem, between January and December 2024. This includes about $623 million out of $600 million (104 per cent) requested for January-March 2024 and about $395 million out of $2.8 billion (14 per cent) requested for the Flash Appeal launched on 17 April to cover the period between April and December 2024. For funding analysis, please see the Flash Appeal Financial Tracking dashboard.
• The oPt HF has 118 ongoing projects, for a total of $72.5 million, addressing urgent needs in the Gaza Strip (85 per cent) and West Bank (15 per cent). The HF has allocated an additional $22 million to bolster prioritized HF-funded projects in Gaza. Recently, 14 projects for a total of $5 million have been approved under the Third Reserve Allocation titled "Critical Humanitarian Aid for Gaza Amidst Escalating Conflict and Displacement (Phase 3)." Following a steep rise in displacement from Rafah to Khan Younis and Deir al Balah and to capitalize on the operational presence of national partners, these projects will be implemented by national NGOs (12 projects) or through a partnership between international and national NGOs (2 projects). Since 7 October, the oPt HF has mobilized over $100 million from Member States and private donors, designated for programmes throughout Gaza. A summary of the oPt HF activities and challenges in April 2024 is available through this link and the 2023 Annual Report of the oPt HF can be accessed here. Private donations are collected directly through the Humanitarian Fund.

For the Gaza Humanitarian Response Update for the period between 20 and 26 May, please visit: Gaza Humanitarian Response Update | 20–26 May 2024. As of 3 June, the Gaza Humanitarian Response Update will be issued every two weeks. The next update will be issued on 12 June, covering the two-week period between 27 May and 9 June.